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metabolic surgery and diabetes

S Chiappetta, R Weiner
BACKGROUND: The Mini gastric bypass/One anastomosis gastric bypass (MGB/OAGB) was the third most commonly performed procedure in Germany, with 13.9% of all obesity and metabolic procedures in 2017 (StuDoQ|MBE). OBJECTIVE: This article reviews the currently published evidence for MGB/OAGB and the historical evidence on one anastomosis reconstruction. MATERIAL AND METHODS: A systematic literature search was performed in MEDLINE via PubMed and in Clinicaltrials...
June 21, 2018: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Aaron J Guyer
The surgical treatment of diabetic patients can be challenging. The physiologic and metabolic abnormalities seen in diabetic patients can adversely affect healing and outcomes in even the simplest of procedures. This article examines some of the special considerations in the treatment of diabetic patients undergoing foot and ankle surgeries.
July 2018: Orthopedic Clinics of North America
Maria Q B Petzel, Leah Hoffman
With slowly increasing survival rates in pancreatic cancer and international consensus guidelines recommending surgical resection of premalignant lesions, survival post-pancreatic resection is increasing. With longer survival time, the significant comorbidities of such major surgery have far-reaching effects on the nutrition status of the survivor of pancreatic cancer. This review describes the many nutrition-related side effects of pancreatic surgery, including the development of pancreatic enzyme insufficiency, micronutrient deficiencies, diabetes, fatty liver, and metabolic bone disease...
October 2017: Nutrition in Clinical Practice
Elin Rebecka Carlsson, Josefine Liv Gilling Grundtvig, Sten Madsbad, Mogens Fenger
Metabolic surgery is superior to lifestyle intervention in reducing weight and lowering glycemia and recently suggested as treatment for type 2 diabetes mellitus. Especially Roux-en-Y gastric bypass (RYGB) has been focus for much research, but still the mechanisms of action are only partly elucidated. We suggest that several mechanisms might be mediated by sphingolipids like sphingomyelin. We measured serum sphingomyelin before and up to 2 years after RYGB surgery in 220 patients, divided before surgery in one non-diabetic subgroup and two diabetic subgroups, one of which contained patients obtaining remission of type 2 diabetes after RYGB, while patients in the other still had diabetes after RYGB...
2018: Frontiers in Endocrinology
Miguel F Herrera, Eduardo García-García, Juan F Arellano-Ramos, Miguel Agustín Madero, Jorge Antonio Aldrete-Velasco, Juan Antonio López Corvalá
INTRODUCTION: Metabolic surgery (MS) can be a useful therapeutic strategy in patients with type 2 diabetes (DM2) and obesity. OBJECTIVE: To define the place of MS within DM2 treatment in Mexico. METHODS: A committee of experts consisting of internists and surgeons representing the leading Mexican associations involved in the field was created. Each one responded to a specific question regarding mechanisms involved in controlling DM2, surgical procedures, and the indications and contraindications for MS...
June 18, 2018: Obesity Surgery
Mattia Barbot, Filippo Ceccato, Carla Scaroni
Associated with important comorbidities that significantly reduce patients' overall wellbeing and life expectancy, Cushing's disease (CD) is the most common cause of endogenous hypercortisolism. Glucocorticoid excess can lead to diabetes, and although its prevalence is probably underestimated, up to 50% of patients with CD have varying degrees of altered glucose metabolism. Fasting glycemia may nevertheless be normal in some patients in whom glucocorticoid excess leads primarily to higher postprandial glucose levels...
2018: Frontiers in Endocrinology
Corey J Lager, Nazanene H Esfandiari, Yingying Luo, Angela R Subauste, Andrew T Kraftson, Morton B Brown, Oliver A Varban, Rasimcan Meral, Ruth B Cassidy, Catherine K Nay, Amy L Lockwood, Darlene Bellers, Colleen M Buda, Elif A Oral
BACKGROUND: Sleeve gastrectomy (LSG) is now the predominant bariatric surgery performed, yet there is limited long-term data comparing important outcomes between LSG and Roux-en-Y gastric bypass (RYGB). This study compares weight loss and impact on comorbidities of the two procedures. METHODS: We retrospectively evaluated weight, blood pressure, hemoglobin A1c, cholesterol, and medication use for hypertension, diabetes, and hyperlipidemia at 1-4 years post-operatively in 380 patients who underwent RYGB and 334 patients who underwent LSG at the University of Michigan from January 2008 to November 2013...
June 16, 2018: Obesity Surgery
Megan E Capozzi, Richard D DiMarchi, Matthias H Tschöp, Brian Finan, Jonathan E Campbell
Glucagon-like peptide-1 (GLP-1) receptor agonists have been efficacious for the treatment of type 2 diabetes due to their ability to reduce weight and attenuate hyperglycemia. However, the activity of GLP-1R-directed strategies is sub-maximal, and the only potent, sustainable treatment for metabolic dysfunction is bariatric surgery, necessitating the development of novel therapeutics. GLP-1 is structurally related to glucagon and glucose-dependent insulinotropic peptide (GIP), allowing for the development of intermixed, unimolecular peptides with activity at each of their respective receptors...
June 13, 2018: Endocrine Reviews
Vance L Albaugh, Naji N Abumrad
Obesity prevalence continues to increase worldwide, as do the numerous chronic diseases associated with obesity, including diabetes, non-alcoholic fatty liver disease, dyslipidemia, and hypertension. The prevalence of bariatric surgery also continues to increase and remains the most effective and sustainable treatment for obesity. Over the last several years, numerous prospective and longitudinal studies have demonstrated the benefits of bariatric surgery on weight loss, mortality, and other chronic diseases...
2018: F1000Research
Judith Aron-Wisnewsky, Edi Prifti, Eugeni Belda, Farid Ichou, Brandon D Kayser, Maria Carlota Dao, Eric O Verger, Lyamine Hedjazil, Jean-Luc Bouillot, Jean-Marc Chevallier, Nicolas Pons, Emmanuelle Le Chatelier, Florence Levenez, Stanislav Dusko Ehrlich, Joel Dore, Jean-Daniel Zucker, Karine Clément
OBJECTIVES: Decreased gut microbial gene richness (MGR) and compositional changes are associated with adverse metabolism in overweight or moderate obesity, but lack characterisation in severe obesity. Bariatric surgery (BS) improves metabolism and inflammation in severe obesity and is associated with gut microbiota modifications. Here, we characterised severe obesity-associated dysbiosis (ie, MGR, microbiota composition and functional characteristics) and assessed whether BS would rescue these changes...
June 13, 2018: Gut
Sharon Li Ting Pek, Anton Kui Sing Cheng, Michelle Xueqin Lin, Moh Sim Wong, Eric Chan Zit Liang, Angela Mei Chung Moh, Chee Fang Sum, Su Chi Lim, Subramaniam Tavintharan
OBJECTIVE: Obesity confers substantial excess risk for morbidity and mortality, especially for Type 2 diabetes (T2D). Leucine-Rich-α2-Glycoprotein 1 (LRG1), a novel pro-inflammatory factor, was recently reported to be higher in patients with T2D with complications of peripheral arterial disease. Association of LRG1, obesity and weight loss is unknown. We examined whether plasma LRG1 is associated with obesity in health screening participants and if it predicts future weight loss in morbidly obese patients after metabolic/bariatric surgery...
June 8, 2018: Diabetes/metabolism Research and Reviews
Abdullah Alkandari, Hutan Ashrafian, Thozhukat Sathyapalan, Peter Sedman, Ara Darzi, Elaine Holmes, Thanos Athanasiou, Stephen L Atkin, Nigel J Gooderham
Background: The global pandemic of obesity and the metabolic syndrome are leading causes of mortality and morbidity. Bariatric surgery leads to sustained weight loss and improves obesity-associated morbidity including remission of type 2 diabetes. MicroRNAs are small, endogenous RNAs that regulate gene expression post-transcriptionally, controlling most of the human transcriptome and contributing to the regulation of systemic metabolism. This preliminary, longitudinal, repeat sampling study, in which subjects acted as their own control, aimed to assess the temporal effect of bariatric surgery on circulating microRNA expression profiles...
2018: BMC Obesity
Moloud Payab, Parisa Goodarzi, Najmeh Foroughi Heravani, Mahdieh Hadavandkhani, Zeinab Zarei, Khadijeh Falahzadeh, Bagher Larijani, Fakher Rahim, Babak Arjmand
Obesity as a worldwide growing challenge is determined by abnormal fat deposition, which may damage general health. Weight loss and control of related risk factors like type2 diabetes, dyslipidemia, hypertension, cardiovascular diseases, and metabolic syndrome is an important concern in obesity management. Different therapeutic approaches such as lifestyle change, medications, and surgery are introduced for obesity treatment. Despite of gaining partially desirable results, the problem is remained unsolved. Therefore, finding a new approach that can overcome previous limitations is very attractive for both researchers and clinicians...
June 7, 2018: Advances in Experimental Medicine and Biology
Xiaoping Chen, Xiaomu Kong
Obesity and type 2 diabetes mellitus are prevalent all over the world. Obese patients with more visceral fat are more likely to suffer from type 2 diabetes mellitus, hypertension, dyslipidemia and obstructive sleep apnea. Obese patients with type 2 diabetes mellitus have higher risk of obesity and diabetes related complications (especially arteriosclerotic cardiovascular disease). This article is protected by copyright. All rights reserved.
June 5, 2018: Journal of Diabetes Investigation
Wei-Jei Lee, Owaid Almalki
Obesity and type 2 diabetes mellitus (T2DM) are currently two pan-endemic health problems worldwide and are associated with considerable increase in morbidity and mortality. Both diseases are closely related and very difficult to control by current medical treatment, including diet, drug therapy and behavioral modification. Bariatric surgery has proven successful in treating not just obesity but also in significantly decreasing overall obesity-associated morbidities as well as improving quality of life in severely obese patients (body mass index [BMI] >35 kg/m2 )...
September 2017: Annals of gastroenterological surgery
Wei Yan, Zhi-Peng Sun, Dong-Bo Lian, Qing Fan, Kai Li, Chen Liu, Dong-Dong Zhang, Guang-Zhong Xu, De-Xiao Du, Gang Yin, Buhe Amin, Ke Gong, Bin Zhu, Ji-Run Peng, Neng-Wei Zhang
Bariatric surgery is effective in treating different components of metabolic syndrome including obesity, type 2 diabetes mellitus (T2DM), and hyperlipidemia. But there is no consensus on the ideal biliopancreatic and Roux limb length. This study aimed to explore the effect of biliopancreatic limb and Roux limb lengths during laparoscopic Roux-en-Y gastric bypass (LRYGB) procedures on weight loss and T2DM control.We studied the clinical records of 58 patients with metabolic syndrome, T2DM, and body mass index (BMI) 32 to 50 kg/m who underwent LRYGB in our hospital...
June 2018: Medicine (Baltimore)
Sara J Brandt, Maximilian Kleinert, Matthias Tschöp, Timo Müller
Obesity is a world-wide pandemic which can be fatal for the most extremely affected individuals. Lifestyle interventions such as diet and exercise are largely ineffective, and current anti-obesity medications offer little in the way of significant or sustained weight loss. Bariatric surgery is effective, but largely restricted to only a small subset of extremely obese patients. While the hormonal factors mediating sustained weight loss and remission of diabetes by bariatric surgery remain elusive, a new class of polypharmacological drugs shows potential to shrink the gap in efficacy between a surgery and pharmacology...
May 30, 2018: Journal of Endocrinology
Lei Zhao, Weizheng Li, Zhihong Su, Yong Liu, Liyong Zhu, Shaihong Zhu
OBJECTIVE: This study investigated the role of preoperative fasting C-peptide (FCP) levels in predicting diabetic outcomes in low-BMI Chinese patients following Roux-en-Y gastric bypass (RYGB) by comparing the metabolic outcomes of patients with FCP > 1 ng/ml versus FCP ≤ 1 ng/ml. METHODS: The study sample included 78 type 2 diabetes mellitus patients with an average BMI < 30 kg/m2 at baseline. Patients' parameters were analyzed before and after surgery, with a 2-year follow-up...
May 29, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Prapimporn Chattranukulchai Shantavasinkul, Michael J Muehlbauer, James R Bain, Olga R Ilkayeva, Damian M Craig, Christopher B Newgard, Laura P Svetkey, Svati H Shah, Alfonso Torquati
BACKGROUND: Gastric bypass surgery for weight reduction often corrects dysglycemia in diabetic patients, but a full understanding of the underlying biochemical pathways continues to be investigated. OBJECTIVES: To explore the effects of weight loss by surgical and dietary interventions on plasma metabolites using both targeted and discovery-oriented metabolomics platforms. SETTING: An academic medical center in the United States. METHODS: Improvement in homeostatic model assessment for insulin resistance (HOMA-IR), as an index of insulin resistance, was compared at 6 months in 11 patients that underwent Roux-en-Y gastric bypass against 11 patients that were matched for weight loss in the Weight Loss Maintenance (WLM) program...
April 17, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Bárbara G Patrício, Tiago Morais, Marta Guimarães, Simon Veedfald, Bolette Hartmann, Linda Hilsted, Jens J Holst, Mário Nora, Mariana P Monteiro
BACKGROUND/OBJECTIVES: Changes in gut hormone secretion are important for the anti-diabetic effects of bariatric surgery. Roux-en-Y gastric bypass (RYGB) with extended biliopancreatic limb (BPL) length may improve the metabolic outcomes when compared to the classical procedure. The purpose of this study was to compare the gut hormone responses to a liquid mixed meal after RYGB with one of two different BPL lengths. SUBJECTS/METHODS: Non-diabetic weight-stable individuals previously submitted to classical RYGB (n = 9; BPL length: 87...
May 24, 2018: International Journal of Obesity: Journal of the International Association for the Study of Obesity
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